鼻咽癌患者鼻咽组织和血清中EBV检测

目的：比较血清爱泼斯坦－巴尔病毒（ＥＢＶ）抗体滴定度测定与癌组织ＥＢＶ基因组检测对鼻咽癌（ＮＰＣ）的诊断价值。方法：１４６例患者采用双盲法测定血清ＥＢＶ－ＶＣＡ－ＩｇＡ,ＥＢＶ－ＥＡ－ＩｇＡ和活检组织ＥＢＶ－ＤＮＡ（ＰＣＲ）。全组病例按活检病理检查结果分析：ＮＰＣ组,非ＮＰＣ组（对照组）。结果：ＮＰＣ组中ＥＢＶ－ＤＮＡ（ＰＣＲ）,ＥＢＶ－ＶＣＡ－ＩｇＡ和ＥＢＶ－ＥＡ－ＩｇＡ的阳性率分别为９０．８％     

激光扁桃体部分凝固术

应用ＹＡＧ激光对５０例慢性扁桃体炎患者的扁桃体组织作部分凝固术，通过对激光治疗前后的血清ＩｇＧ，ＩｇＡ，ＩｇＭ及补体Ｃ３浓度的检测；急性时相反应蛋白中的α１－酸性糖蛋白，α１－抗胰蛋白酶及转铁蛋白浓度的检测；局部组织光镜，透射电镜检查；结合临床随访６－１２个月；认为本方法可达到消除局部炎症，又保留扁桃体免疫功能的目的。     

激光扁桃体部分凝固术

应用ＹＡＧ激光时５０例慢性扁桃体炎患者的扁桃体组织作部分凝固术，通过对激光治疗前后的血清ＩｇＧ、ＩｇＡ、ＩｇＭ及补体Ｃ＿３浓度的检测；急性时相反应蛋白（ＡＰＲＰｓ）中的ｘ＿１－酸性糖蛋白（α＿１－ＡＧＰ），ｘ＿１－抗胰蛋白酶（ｘ＿１－ＡＴ）及转铁蛋白（Ｔｆ）浓度的检测；局部组织光镜、透射电镜检查；结合临床随访６～１２个月，认为本方法可达到消除局部炎症，又保留扁桃体免疫功能的目的。     

鼻咽癌活检组织及外周血白细胞EB病毒DNA的检测及其意义

目的：探讨鼻咽组织、外周血血白细胞ＥＢＶ基因组分布及与ＮＰＣ的关系。方法：采用ＰＣＲ法检测２６例ＮＰＣ,４例癌旁及１４例慢性鼻咽炎鼻 组织吸外周血白细胞中ＥＢＶ ＤＮＡ。同时采用酶免疫法测定血清ＶＣＡ－ＬｇＡ。结果：１．ＮＰＣ、癌旁及鼻咽炎组织ＥＢＶ ＤＮＡ无明显差异。２．ＮＰＣ与鼻咽炎组外周血白细胞ＥＢＶ ＤＮＡ有明显差异,Ｐ〈０．０５。３．ＮＰＣ与鼻咽炎组血清ＶＣＡ－ＩｇＡ之间存在明显差异。Ｐ     

鼻咽脱落细胞的AgNOR定量观察对鼻咽癌的诊断意义

本文对临床诊断为鼻咽癌（ｎａｓｏｐｈａｒｙｎｇｅａｌｃａｒｃｉｎｏｍａ，ＮＰＣ）者２０８例分别行鼻咽脱落细胞、病理活检、组织印片及血清免疫酶测定ＶＣＡ－ＩｇＡ，结果发现活检（第１次）准确率为８５．７％，组织印片为８８．９％，涂片ＨＥ染色为６３．４％，涂片ＡｇＮＯＲ为９０．５％，ＶＣＡ－ＩｇＡ为７８．６％。以脱落细胞涂片ＡｇＮＯＲ染色准确率最高。认为该方法简便，快速，不失为ＮＰＣ诊断的一种有意义的辅助方法。     

耳廓假性囊肿免疫学病因的初步探讨

目的　探讨耳廓假性囊肿发病与全身免疫功能及局部免疫状态的关系。方法　采集４４ 例耳廓假性囊肿患者的囊液和外周静脉血标本，用免疫单扩散法分别检测囊液和血清中的抗体ＩｇＧ、ＩｇＡ、ＩｇＭ 和补体Ｃ３ 水平；用聚乙二醇比浊法分别检测囊液和患者血清中的免疫复合物含量；用聚合酶链反应检测囊液中巨细胞病毒ＤＮＡ；用免疫荧光技术检测囊液和血清中的抗核抗体，用间接荧光抗体检测法（ｉｎｄｉｒｅｃｔｉｍｍｎｏｆｌｕｏｒｅｓｃｅ ａｓｓａｙ，ＩＦＡ） 检查囊液和患者血清与健康小鼠耳廓冰冻组织切片的反应情况。结果　耳廓假性囊肿患者囊液中抗体ＩｇＧ、ＩｇＡ、ＩｇＭ 和补体Ｃ３ 水平均明显低于血清中者（ Ｐ＜ ０．０１），囊液和患者血清中均未检出免疫复合物，囊液中也未检测出巨细胞病毒ＤＮＡ；但在部分（３／１０） 患者囊液中发现了抗核抗体，在小鼠冰冻切片中发现了位于软骨组织上的抗原抗体复合物。结论　耳廓假性囊肿中部分患者可能是局限于耳廓的自身免疫性疾病，可能是由于自身抗体与耳廓组织发生自身免疫反应导致反应性渗出液在局部聚集形成囊肿。     

鼻咽脱落细胞的AgNOR定量观察对鼻咽癌的诊断意义

本文对临床诊断为鼻咽癌（ｎａｓｏｐｈａｒｎｇｅａｌ ｃａｒｃｉｎｏｍａ，ＮＰＣ）者２０８例分别行鼻咽脱落细胞、病理活检、组织印片及血清免疫酶测定ＶＣＡ－ＩｇＡ，结果发现活检（第１次）准确率为８５．７％，组织印片为８８．９％，涂片ＨＥ染色为６３．４％，涂片ＡｇＮＯＲ为９０．５％，ＶＣＡＩｇＡ为７８．６％。以脱落细胞涂片ＡｇＮＯＲ染色准确率最高。认为该方法简便，快速，不失为ＮＰＣ诊断的一种有意义的辅助     

耳廓假性囊肿免疫学病因的初步探讨

目的 探讨耳廓假性囊肿发病与全身免疫功能及局部免疫状态的关系。方法 采集４４例耳廓假性囊肿患者的囊液和外周静脉血标本,用免疫单扩散法分别检测囊液和血清中的抗体ＩｇＧ、ＩｇＡ、ＩｇＭ和补体Ｃ３水平;用聚乙二醇比浊法分别检测囊液和患者血液中的免疫复合物含量;用聚合酶链反应检测囊液中巨细胞病毒ＤＮＡ;用免疫荧光技术检测囊液和血清中的抗核抗体,用间接荧光抗体检测法（ＩＦＡ）检查囊液和患者血清与健康小鼠耳廓     

鼻咽粘膜异常与鼻咽癌相关的前瞻性观察

在鼻咽癌高发区对３０－６４岁４３５４１健康人群进行了六年ＥＢ病毒血清学和鼻咽检查的前瞻性观察，对其中ＶＣＡ－ＩｇＡ阳性者及高滴度＞１：４０所对应的阴性对照者或有鼻咽粘膜异常者作为观察对象，共３７３７人。结果提示：（１）鼻咽粘膜异常多见于青壮年；部位以顶后壁最多；常呈滤泡增生和膨隆。（２）鼻咽粘膜异常组与无鼻咽粘膜异常组。ＶＣＡ－ＩｇＡ（壳抗原抗体ＩｇＡ）阳性率与几何平均滴度均无差异；粘膜异常患者百     

腭扁桃体免疫学异常与IgA肾病

ＩｇＡ肾病是肾小球系膜区以ＩｇＡ沉积为主，临床上以血尿为主要表现的肾小球肾炎。此病是许多国家和地区主要的肾小球疾病之一，也是导致终末末期肾功能衰竭的一个重要原因。很多表明ＩｇＡ病患扁桃体免疫学异常，扁桃体切除术对一些ＩｇＡ肾病有一定疗效。     

耳廓假性囊肿与机体免疫功能的关系

目的 :探讨耳廓假性囊肿发病与机体免疫功能的关系。方法 :采集 5 5例耳廓假性囊肿患者的囊液和血清 ,分别用免疫单扩散法、聚乙二醇比浊法、间接荧光抗体技术和免疫转印技术等检测其中的抗体 Ig G、Ig A、Ig M,补体 C3 ,免疫复合物以及抗核抗体、ENA多态抗体等的含量 ;用免疫组织化学方法检测患者囊壁组织中的免疫复合物。以患者血清、囊液以及正常人血清分别与实验大鼠耳廓和正常胎儿耳廓组织作用后观察反应情况。结果 :耳廓假性囊肿患者囊液中抗体和补体含量均明显低于血清中含量 (P <0 .0 1) ,在患者病变耳廓软骨组织上发现了免疫复合物沉积。患者囊液与正常胎儿耳廓组织作用后也发现了免疫复合物沉积。结论 :耳廓假性囊肿的发生可能与机体局部自身免疫有一定关系。     

分泌性中耳炎患者血清,中耳积液补体和免疫复合物含量测定

２０例（２０耳）分泌性中耳炎患者血清与对照组血清比较，Ｃ５、Ｃ１－ＩＮＨ含量明显增高，Ｃ９、Ｂ因子（Ｂｆ）含量明显降低，免疫复合物（ＩＣ）含量明显升高。患者的中耳积液与血清比较，Ｃ３、Ｃ４、Ｃ５含量明显降低，Ｂｆ含量明显增高，ＩＣ含量明显增高，提示补体对ＩＣ清除等功能降低，有可能引起ＩＣ沉积在中耳粘膜，从而导致毛细血管通透性增加，出现中耳积液。     

Infection of Haemophilus parainfluenzae in tonsils is associated with IgA nephropathy

We investigated the functions of tonsillar mononuclear cells (TMC) regarding whether a Haemophilus parainfluenzae (HP) outer membranes antigen (HPOM) enhances IgA-related cytokine (IFN-gamma, IL-10. and TGF-beta) production in vitro by TMC in IgA nephropathy (IgAN) patients. In addition, we examined the effect of synthetic oligodeoxynucleotide and HPOM stimulation by TMC on IgA production, whether the constant region antisense to IgA inhibits the production of IgA in vitro by TMC. Eighteen patients with IgAN and 25 patients with chronic tonsillitis (CT) from 6 to 45 years (mean age of 20.9 years) participated in this study. TMC were obtained from resected tonsils, and total and HP-specific IgA levels, along with the concentration of TGF-beta, IL-10 and IFN-gamma in the supernatant of stimulated TMC were measured by ELISA. Isolated TMC were cultured with HPOM in the presence of 23 oligodeoxynucleotides (ODNs), and the induction of total IgA and HP-specific IgA in the supernatant was also measured using ELISA. To investigate the inhibition of IgA production, TMC were cultured with HPOM and antisence to IgA. We found that IgA-related cytokine (IFN-gamma, IL-10, and TGF-beta) production by unstimulated or stimulated TMC was higher in IgAN patients than CT patients. Two types of synthetic oligodeoxynucleotides produced higher HP-specific IgA than with HPOM stimulation alone. HPOM and antisence IgA inhibited the production of total IgA and HP-specific IgA in dose-depend manner. In conclusion, IFN-gamma, TGF-beta, and IL-10 influence each other in the pathogenesis of IgAN, and infection by not only HP but other bacteria or viruses which possess specific DNA sequences such as CpG motifs induce the production of HP-specific IgA by TMC.     

无症状鼻咽癌临床分析和长期随访研究

目的：观察无症状鼻咽癌Epstein-Barr(EB)病毒血清学、鼻咽纤维镜表现和预后。方法：1986年12月采用免疫酶标法检测血清EB病毒壳抗原抗体（viral capsid antigen‘s IgA,VCA-IgA)、早期抗原抗体（early antigen‘s IgA,EA-IgA)，行间接鼻咽镜和鼻咽纤维镜检查及多部位活体组织检查。确诊鼻咽癌后行根治性放射治疗，随访至1999年底。结果：早期无症状鼻咽癌患者确诊时血清EB病毒VCA－IgA、EA－IgA抗体水平分别为1：100．79、1：10．76，与有症状患者比较差异无显著性意义（P＞0．05）。有、无症状患者生存率比较差异有显著性意义（χ^2=6.73,P=0.009)。有、无症状患者确诊时血清VCA－IgA、EA－IgA滴度水平与患者预后均无关（P＞0．05），与是否出现颈淋巴结转移无关（P＞0．05）。结论：定期检测EB病毒抗体、鼻咽纤维镜检查及多部位活体组织检查，有助于检出早期鼻咽癌，尤其是无症状鼻咽癌。     

Correlation of immunoglobulins, the complement system and inflammatory mediators with reference to the pathogenesis of serous otitis media

Otitis media with effusion (OME) is a very common pediatric disease of unknown etiology which sometimes leads to chronic recurrent OME. The author investigated 90 secretions (39 serous/51 mucous) of 61 children whose ages ranged from 1 to 14 years (mean = 4.9 +/- 2.2) for correlations of Immunoglobulins A, E, G, M, the complement system and mediators of inflammation: histamine, Bradykinin, PGE2 and LTC4. A highly significant increase in IgA and IgG and a decrease in IgM and IgE were found in the secretions as compared to the serum concentrations. These data support the hypothesis that there is an independent mucosal immune response in the middle ear. The protein concentration was significantly higher in the mucous than in the serous secretion; for the other parameters determined only a slight tendency toward higher levels in serous secretions was found. There was a slight positive correlation between IgA and IgG in serum, and in particular in the serous secretions. A slightly negative correlation between IgM and IgE was found only in serum. The secretion showed highly significant correlations between the following: IgG:IgM, IgG:IgA, IgA:IgM, IgG:Kinin, C3c:Kinin and lg Histamine:lg PGE2. The correlations were stronger in serous than in mucous secretions. Only in mucous secretions there were any significant correlations between IgE:IgG, lg IgE:lg Kinin, and a negative correlation between IgE:C3c. Serous and mucous secretions represent different stages of inflammation. The kallikrein kinin system, complement-system, and the arachidonic acid cascade, especially the cyclo-oxygenase pathway, play a role in OME. Bradykinin showed a connection between the activated complement system and the immune system.(ABSTRACT TRUNCATED AT 250 WORDS)     

Humoral mucosal immunity in allergic rhinitis

BACKGROUND: Mucosa-immunologic aspects are gaining an increasing awareness in the pathophysiology of type I allergies. Humoral mucosal immune responses are dominated by secretory IgA, but there is evidence for a relevant role of IgG in nasal mucosa-associated lymphoid tissue. OBJECTIVE: was to measure allergen-specific immunoglobulins (IgA and IgG) in nasal secretions as an expression of a humoral mucosal immune response in allergic rhinitis. For tissue eosinophilia we studied nasal Eosinophilic Cationic Protein (ECP) and for mast cell activation nasal tryptase. METHODS: Nasal secretions of 40 patients suffering from allergic rhinitis were analyzed for allergen-specific IgA, IgG, and IgE, and for ECP and tryptase. Patients were highly sensitized against the major allergens of house dust mites, timothy, and birch pollen. 43 non-atopic individuals served as controls. In order to study possible effects of the actual pollen season on the studied parameter we secondly compared patients allergic to seasonal allergens co- (n = 28) and extra-seasonally (n = 41). In order to determine a possible influence of allergen-specific IgA in eosinophilic degranulation we additionally studied 5 patients after nasal allergen challenge. RESULTS: In allergic rhinitis we found significantly increased levels of allergen-specific immunoglobulins of all studied subclasses and allergens in nasal secretions. Comparison of nasal ECP and tryptase showed significantly increased concentrations in allergic individuals as well. Co-seasonally we found elevated allergen-specific IgE, ECP, and tryptase but lower concentrations of allergen-specific IgA and IgG. There was no association between late phase eosinophilia and IgA concentrations after local allergen challenge. CONCLUSIONS: The occurrence of allergen-specific immunoglobulins in nasal secretions is interpreted as a local humoral mucosal immune response. The physiologic role of local allergen-specific immunoglobulins is not clear to date. Involvement in degranulation of eosinophils or mast cells, like suggested before, seems unlikely.     

Therapeutic effects and prognostic factors of tonsillectomy for IgA nephropathy in long-term follow-up

I investigated several factors that can predict the effect of tonsillectomy for the prevention of renal failure in IgA nephropathy patients. Samples were obtained from 71 patients (35 male and 36 female) who were diagnosed as having IgA nephropathy by renal biopsy and the patients were followed-up for more than 5 years. Mean age at the time of renal biopsy was 28.3 years (8-58 years), and the mean follow-up period was 9 years 9 months (5-19 years). The overall remission rate of IgA nephropathy after tonsillectomy was 28.2%, and the retention rate of renal function was 90.1%, showing a considerably better prognosis than alternative therapies previously reported. Statistical analysis of multiple prognostic factors were examined including the following: sex, age-at-biopsy, renal pathological findings, renal function, serum IgA level, hypertension, past history of tonsillitis, preoperative results of tonsillar provocation test, and the period from diagnosis to tonsillectomy. A statistically significant poorer prognosis after tonsillectomy was observed in the following conditions: < or = 20-years-old when diagnosed, serum creatinine level > or = 1.3 mg/dl, urinary protein > or = 1.0 g/day, serum IgA level > or = 350 mg/dl. No other factors affected the prognosis of renal function statistically, including past history of tonsillitis or positive result of tonsillar provocation test. The present study indicates that there is a beneficial effect of tonsillectomy for mild to moderate IgA nephropathy and that this operation may be indicated for IgA nephropathy as long as the pathological grading is not advanced. On the other hand, tonsillectomy was not effective in cases with poor renal function. Although a past history of tonsillitis and positive results in tonsillar provocation tests have been widely considered as good indicators of tonsillectomy for IgA nephropathy, the present study showed no benefit to consideration of these factors preoperatively.     

Role of local immunoglobulin E specific for Alternaria alternata in the pathogenesis of nasal polyposis

OBJECTIVE/HYPOTHESIS: The role of fungal pathogens in the etiology of nasal polyposis remains unclear. The aim of this study was to determine whether there was a correlation between the presence of Alternaria-specific immunoglobulin (Ig)E antibodies, eosinophilic inflammation, and the development of nasal polyps. STUDY DESIGN: Prospective study. METHODS: Serum and nasal tissue homogenates from 21 patients with manifestations of chronic sinusitis with nasal polyps were compared with specimens from 13 chronic sinusitis patients without polyps and 8 healthy controls. The Phadia ImmunoCAP and enzyme-linked immunosorbent assay were used to quantify levels of total IgE and Alternaria-specific (IgE, IgG, and IgA) antibodies. Eosinophil cationic protein (ECP) and tryptase levels were measured in tissue homogenates, whereas the inflammatory response was evaluated using tissue eosinophil counts in tissue samples. RESULTS: Serum analysis revealed no difference in the levels of total IgE and Alternaria-specific IgE, IgG, and IgA antibodies between the study groups. In contrast, the levels of Alternaria-specific IgE in tissue with polyps were significantly higher than in nonpolyp tissue. Increases in total tissue IgE paralleled increased levels of Alternaria-specific IgG and IgA antibodies in chronic sinusitis with nasal polyps as compared with control groups. A positive correlation was found between Alternaria-specific IgE and ECP in tissue. Increased mean levels of ECP corresponded to increased eosinophil counts in the group of patients with polyps. CONCLUSIONS: Alternaria-specific IgE and eosinophilic inflammation in nasal tissue correlates with the incidence of nasal polyps irrespective of specific IgE antibodies in serum. Together, the correlation between the local immune responses and the eosinophilic inflammation in nasal polyps suggests a possible role of Alternaria in the pathogenesis of nasal polyposis.